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Research ArticleOriginal Research

Principles of the Patient-Centered Medical Home and Preventive Services Delivery

Jeanne M. Ferrante, Bijal A. Balasubramanian, Shawna V. Hudson and Benjamin F. Crabtree
The Annals of Family Medicine March 2010, 8 (2) 108-116; DOI: https://doi.org/10.1370/afm.1080
Jeanne M. Ferrante
MD, MPH
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Bijal A. Balasubramanian
MBBS, PhD
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Shawna V. Hudson
PhD
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Benjamin F. Crabtree
PhD
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Table 4.

Table 4.

Association of Principles of PCMH With Percentage of Preventive Services Received

Receipt of Preventive Services
Principles of PCMHβa (95% CI)P Value
PCMH = patient-centered medical home; Ref = reference.
a Adjusted for patient age, sex, race/ethnicity, education level, insurance status, and self-rated health while accounting for correlation between patients within practices. Each β is from a separate model.
b Analyzed as continuous variable.
c Use of e-mail with patients was not included in multivariate models because of unstable estimates (only 3 practices used e-mail).
Global PCMH score2.3 (1.4 to 3.2)<.001
High-touch principles3.4 (2.2 to 4.5)<.001
Personal physician3.7 (1.7 to 5.8)<.001
    Months patient enrolled in practice0.03 (−0.01 to 0.07)b.13b
    Number of visits in previous 2 years0.9 (0.6 to 1.3)b<.001b
        <5Ref
        5–89.6 (4.6 to 14.7)<.001
        9–1212.4 (7.6 to 17.2)<.001
        ≥1315.3 (10.6 to 20.1)<.001
    Patient sees same doctor when getting care at practice4.4 (1.6 to 7.1).002
    Patient contacts primary care practice first when ill0.5 (−1.3 to 2.3).56
Physician-directed team1.8 (−1.8 to 5.4).32
    Practice has nurse practitioners or physician assistants0.5 (−5.4 to 6.5).86
    Practice uses nurses/health educators for preventive counseling3.1 (−2.6 to 8.7).29
    Practice leadership seeks nursing input for making changes1.0 (−1.2 to 3.4).37
Whole-person orientation5.6 (4.2 to 7.1)<.001
    Well-visit in last 5 years12.3 (7.6 to 17.1)<.001
    Treated at practice for acute illness0.7 (−3.9 to 5.3).78
    Number of chronic diseases2.8 (1.8 to 3.8)b<.001b
        ≤3Ref
        ≥45.8 (2.8 to 8.8)<.001
Coordination of care1.4 (−0.7 to 3.5).20
    Reports from tests/consultations available during patient visits0.4 (−4.2 to 4.9).87
    Results of tests communicated to patients2.5 (−0.5 to 5.6).10
    Referral system to link patients to community programs8.0 (3.8 to 12.3)<.001
    Clinicians make hospital or nursing home visits0.9 (−4.4 to 6.2).74
High-tech principles0.3 (−1.1 to 1.7).64
Quality and safety0.8 (−1.2 to 2.8).45
    Use of electronic medical records−2.1 (−7.8 to 3.7).48
    Use of information technology1.1 (−4.3 to 6.6).68
    Use of clinical decision support tools5.0 (0.3 to 9.7).04
    Performs continuous quality improvement1.6 (−3.4 to 6.6).52
Enhanced accessc−0.3 (−2.3 to 1.7).74
    Waiting time for appointment−0.2 (−1.4 to 1.0).76
    Getting through the office by telephone−0.4 (−1.9 to 0.9).52
    Use of Web site for marketing−0.3 (−5.8 to 5.2).91

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Principles of the Patient-Centered Medical Home and Preventive Services Delivery
Jeanne M. Ferrante, Bijal A. Balasubramanian, Shawna V. Hudson, Benjamin F. Crabtree
The Annals of Family Medicine Mar 2010, 8 (2) 108-116; DOI: 10.1370/afm.1080

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Principles of the Patient-Centered Medical Home and Preventive Services Delivery
Jeanne M. Ferrante, Bijal A. Balasubramanian, Shawna V. Hudson, Benjamin F. Crabtree
The Annals of Family Medicine Mar 2010, 8 (2) 108-116; DOI: 10.1370/afm.1080
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Subjects

  • Domains of illness & health:
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  • Methods:
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  • Core values of primary care:
    • Coordination / integration of care
    • Personalized care
    • Relationship
  • Other topics:
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    • Patient-centered medical home

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